A recent report by a federal watchdog has unveiled significant inaccuracies in the mental health provider listings within Tricare network directories. This issue could hinder military service members and their families from accessing essential behavioral health care.
The Government Accountability Office (GAO) found that 85% of listings in the Tricare East Region and 79% in the Tricare West Region had issues with location, provider gender, specialty or subspecialty descriptions, or contact information.
These details are crucial for Tricare beneficiaries searching for in-network psychiatrists, psychologists, and therapists, as emphasized in the report released on Monday.
“Network provider directories are essential tools that health plan beneficiaries use to locate available providers in their network, by location and specialty, including behavioral health providers,” the report stated. “Inaccuracies in directories are likely to hinder beneficiaries’ search for behavioral health care from providers who accept Tricare.”
The demand for mental health services within the military health system and the Tricare health program has surged, with mental health diagnoses quadrupling among service members and increasing six-fold among their children over the past two decades. Factors such as combat exposure, long work hours, deployments, frequent relocations, and other military life stressors contribute to this rise, the report noted.
This increase mirrors a nationwide rise in demand for mental health services. Mental Health America, a nonprofit organization, reports that 21% of American adults have a behavioral health condition, and one-third experience difficulties accessing care.
“Due to the widely reported shortages of behavioral health providers, finding these providers can be a significant hardship for beneficiaries — including service members and their families who frequently move and therefore need new providers in different locations,” GAO officials wrote.
Under the current Tricare contract, network providers — Humana Military in the East Region and Health Net Federal Services in the West — must maintain provider locator databases with at least 95% accuracy.
According to the report, Health Net Federal Services’ directory was 81% accurate, and Humana’s was 83% accurate overall this year.
The Defense Health Agency (DHA) does not track accuracy by specialty, nor do the contractors, as they are not required to do so. DHA officials informed the GAO that they do not monitor accuracy at the specialty level because they did not anticipate any differences in accuracy by category.
GAO analysts conducted covert calls to 342 behavioral health providers listed in the Tricare East and West provider directories to assess for errors, estimating the accuracy rates based on these results.
The East and West Region directories include 130,000 listings for 78,000 mental health providers, with multiple listings for those who see patients in different locations.
High levels of inaccuracy in network search engines are not unique to Tricare. The GAO noted similar discrepancies in directories for private insurance companies, Medicare Advantage, and the Department of Veterans Affairs.
“Providers often need to update information for multiple health plans and systems, making the task challenging,” GAO analysts wrote.
The GAO also reviewed portions of a 2023 Defense Health Agency survey to understand why providers do not join the Tricare network. Low reimbursement rates from Tricare deter providers, especially those who can afford to accept only out-of-pocket paying patients. Burnout and a lack of awareness about Tricare also contribute, according to the report.
The GAO made two recommendations to the Defense Department to improve the behavioral health provider databases: first, the DHA should assess and improve the accuracy of the listings to match the accuracy of the entire provider databases; second, the DHA should periodically monitor the mental health provider listings for accuracy.
In response, DHA officials indicated they would consider requiring Tricare contractors to review the behavioral health directory listings. However, they disagreed with parts of the first recommendation and the entirety of the second, citing a lack of staff.
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